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Glucose Abnormalities Are an Independent Risk Factor for Nonresponse to Antiviral Treatment in Chronic Hepatitis C

Lecube, Albert, M.D.1; Hernández, Cristina, M.D.1; Simó, Rafael, M.D.1; Esteban, Juan Ignacio, M.D.2; Genescà, Joan, M.D.2

American Journal of Gastroenterology: October 2007 - Volume 102 - Issue 10 - p 2189–2195
ORIGINAL CONTRIBUTION: LIVER AND BILIARY TRACT
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OBJECTIVES The influence of glucose abnormalities on the efficacy of antiviral treatment is unknown. This study investigated whether glucose abnormalities (impaired fasting glucose and type 2 diabetes) influence the response to antiviral therapy with interferon plus ribavirin in patients with chronic hepatitis C.

METHODS A total of 178 treatment-naïve patients with chronic hepatitis C treated with combination therapy were retrospectively studied. SVR was assessed after completing treatment. Fasting plasmatic glucose was measured prior to therapy.

RESULTS Compared with nonresponders (N = 111), patients with SVR (N = 67) had lower plasma glucose (94.1 ± 12.7 vs 104.4 ± 25.8 mg/dL, P = 0.001) and a lower prevalence of glucose abnormalities (24.24% vs 44.14%, P = 0.012). The SVR rate was 45.13% in patients with normoglycemia (N = 113), 28.26% in patients with impaired fasting glucose (N = 46), and 15.78% in type 2 diabetic patients (N = 19) (P < 0.001). Multivariate logistic regression identified genotype 1 (OR 1.55, 95% CI 1.01–2.41, P = 0.05), γ-glutamyltranspeptidase level (OR 6.41, 95% CI 1.86–22.07, P = 0.003), and presence of glucose abnormalities (OR 2.33, 95% CI 1.04–5.20, P = 0.039) as being independently associated with the absence of an SVR. In addition, patients with glucose abnormalities (N = 65) showed a lower virological response rate when compared with a subgroup of normoglycemic patients (N = 65) matched for sex, age, and liver fibrosis (24.6% vs 44.6%, P = 0.001).

CONCLUSIONS Glucose abnormalities are an independent predictor of poor virological response to combined therapy in hepatitis C virus infected patients.

1Diabetes Research Unit, Endocrinology Division, and 2Liver Unit and Ciberehd Hospital Universitari Vall d'Hebron, Institut de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain

Reprint requests and correspondence: Dr. Albert Lecube, M.D., Endocrinology Division, Hospital Universitari Vall d'Hebron, Pg. Vall d'Hebron 119–129, 08035 Barcelona, Spain.

CONFLICT OF INTEREST The authors declare no potential conflict of interest in the submission.

Received January 12, 2007; accepted May 9, 2007.

© The American College of Gastroenterology 2007. All Rights Reserved.
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